Drill guides for confirming alignment of patient-specific alignment guides

ABSTRACT

An orthopedic device includes a drill guide configured to be mounted on a patient-specific alignment guide for intraoperatively confirming alignment of the patient-specific alignment guide relative to a bone. The patient-specific alignment guide includes first and second referencing holes. The drill guide includes a main body with a first coupling member and a second coupling member. The first and second coupling members are configured to be received within the first and second referencing holes, respectively. The first and second coupling members each include corresponding first and second drill openings configured to align with the first and second referencing holes, respectively. The drill openings each guide a drilling tool toward the bone to drill corresponding holes in the bone. The main body also includes an alignment confirmation feature configured for confirming alignment of the patient-specific alignment guide relative to the bone before drilling holes in the bone.

CROSS-REFERENCES TO RELATED APPLICATIONS

This application is a divisional of U.S. patent application Ser. No.13/493 509, filed Jun 11, 2012, now issued as U.S. Pat. No. 9,084,618,which claims the benefit of U.S. provisional application No. 61/496,085,filed Jun 13, 2011, the benefit of priority of each of which is claimedhereby, and each of which are incorporated by reference herein in itsentirety.

FIELD

The following relates to an orthopedic device and, more particularly,relates to an orthopedic device with a drill guide used for confirmingalignment of a patient-specific alignment guide relative to a bone.

INTRODUCTION

The present teachings provide various drill guides for kneearthroplasty, including femoral and tibial guides. The drill guides areconfigured to reference corresponding patient-specific alignment guidesand confirm the alignment of the patient-specific alignment guidesrelative to the mechanical axis of the knee joint before drilling holesinto the bone through the patient-specific guides.

SUMMARY

An orthopedic device is disclosed. The orthopedic device includes adrill guide configured to be mounted on a patient-specific alignmentguide for intraoperatively confirming alignment of the patient-specificalignment guide relative to a bone. The patient-specific alignment guideincludes first and second referencing holes. The drill guide includes amain body with a first coupling member and a second coupling member. Thefirst and second coupling members are configured to be received withinthe first and second referencing holes, respectively. The first andsecond coupling members each include corresponding first and seconddrill openings configured to align with the first and second referencingholes, respectively. The drill openings each guide a drilling tooltoward the bone to drill corresponding holes in the bone. The main bodyalso includes an alignment confirmation feature configured forconfirming alignment of the patient-specific alignment guide relative tothe bone before drilling holes in the bone.

An orthopedic method is also disclosed. The method includesintraoperatively nesting a three-dimensional patient-specific surface ofa patient-specific alignment guide to a corresponding surface of thebone. The three-dimensional patient-specific surface is preoperativelyconfigured to align the patient-specific alignment guide relative to thebone when nested to the corresponding surface in only one position. Thepatient-specific alignment guide includes a first referencing hole and asecond referencing hole. The method also includes intraoperativelymounting a drill guide onto the patient-specific alignment guide byinserting first and second coupling members of the drill guide into thefirst and second referencing holes, respectively, and aligningcorresponding drill openings of the first and second coupling memberswith the first and second referencing holes, respectively. Moreover, themethod includes intraoperatively confirming that the patient-specificalignment guide is aligned relative to a mechanical axis of the boneusing an alignment confirmation feature of the drill guide. Furthermore,the method includes drilling a hole into the bone through one of thedrill openings after confirming that the patient-specific alignmentguide is aligned relative to the mechanical axis of the bone.

Still further, an orthopedic device is disclosed. The orthopedic deviceincludes a patient-specific alignment guide having a three-dimensionalpatient-specific surface that nests and closely conforms to acorresponding surface of a bone in only one position relative to thebone. The three-dimensional patient-specific surface is pre-operativelyconfigured to align the alignment guide relative to a mechanical axis ofthe bone in only one position. The alignment guide includes a firstreferencing hole and a second referencing hole. Also, the orthopedicdevice includes a drill guide having a main body, a first projection,and a second projection. The first and second projections have first andsecond through holes, respectively, and the first and second projectionsare configured to be received within the first and second referencingholes, respectively, to intra-operatively couple the drill guide to thealignment guide and to guide a drilling tool toward the bone to formcorresponding holes therein. The drill guide additionally includes analignment opening configured to orient a rod along an axis parallel tothe mechanical axis to confirm the alignment of the patient-specificalignment guide relative to the mechanical axis of the bone.

Further areas of applicability of the present teachings will becomeapparent from the description provided hereinafter. It should beunderstood that the description and specific examples are intended forpurposes of illustration only and are not intended to limit the scope ofthe present teachings.

BRIEF DESCRIPTION OF THE DRAWINGS

The present teachings will become more fully understood from thedetailed description and the accompanying drawings, wherein:

FIG. 1 is an isometric view of a drill guide according to variousteachings of the present disclosure;

FIG. 2 is a front view of the drill guide of FIG. 1;

FIG. 3 is a section view of the drill guide taken along the line 3-3 ofFIG. 2;

FIG. 4 is an isometric view of the drill guide of FIG. 1 shown operablycoupled to a patient-specific alignment guide, which is nested on afemur;

FIG. 5 is an isometric view of the femur of FIG. 4 during resection;

FIG. 6 is an isometric view of a drill guide according to additionalteachings of the present disclosure;

FIG. 7 is a front view of the drill guide of FIG. 6;

FIG. 8 is a section view of the drill guide taken along the line 8-8 ofFIG. 7;

FIG. 9 is an isometric view of the drill guide of FIG. 6 shown operablycoupled to a patient specific alignment guide, which is nested on atibia;

FIG. 10 is an isometric view of the tibia of FIG. 9 shown with aresection guide mounted thereon;

FIG. 11 is an isometric view of a drill guide according to additionalteachings of the present disclosure;

FIG. 12 is a front view of the drill guide of FIG. 11;

FIG. 13 is a section view of the drill guide taken along the line 13-13of FIG. 12; and

FIG. 14 is an isometric view of the drill guide of FIG. 11 shownoperably coupled to a patient specific alignment guide, which is nestedon a tibia.

DESCRIPTION OF VARIOUS ASPECTS

The following description is merely exemplary in nature and is in no wayintended to limit the present teachings, applications, or uses. Forexample, although the present teachings are discussed in associationwith resection guides and other instruments for performing knee surgery(e.g., knee arthroplasty), the present teachings can be used inassociation with other guides, templates, jigs, drills, rasps or otherinstruments used in various orthopedic procedures.

The present teachings are directed to various knee arthroplastyprocedures that use patient-specific femoral or tibial alignment guides.The patient-specific alignment guides are configured preoperatively toregister only in one position on the patient's bone and guide a drilltemplate or drill guide to drill holes in the bone through referencingholes of the patient-specific alignment guide. The presents teachingsfurther provide drill guides that can confirm intraoperatively thealignment and registration of the patient-specific guides relative tothe mechanical axis of the bone.

Referring initially to FIGS. 1-4, an orthopedic device 34 for kneearthroplasty, such as implanting a prosthetic device (e.g., a knee jointprosthesis) in a patient's distal femur 35. The orthopedic device 34 caninclude a femoral drill guide 10 and a patient-specific alignment guide36. As shown in FIG. 4, the drill guide 10 is configured to couple tothe alignment guide 36 to intraoperatively confirm that the alignmentguide 36 is properly aligned with respect to the femoral bone. Also, aswill be discussed, the drill guide 10 can be used for guiding a drillingtool (e.g., a drill bit) during formation of one or more holes in thedistal femur 35. The drill guide 10 is illustrated in detail in FIGS.1-3.

Moreover, as will be discussed in relation to FIGS. 9 and 14, orthopedicdevices 134, 234 can be configured for preparing a tibia 155, 255 forthe orthopedic procedure as well. Various exemplary embodiments oftibial drill guide 110, 210 are illustrated in detail in FIGS. 6-8 and11-13.

In each of these embodiments, the alignment of the patient-specificalignment guides 36, 136, 236 can be confirmed with the correspondingfemoral or tibial drill guides 10, 110, 210. Alignment can be confirmedbefore any holes are drilled in the bone, and as such, the overallsurgical procedure can be performed more quickly and efficiently.

As shown in FIGS. 1-3, the femoral drill guide 10 can include a mainbody 12 with a top surface 14, a bottom surface 16, and a side surface18. The top and bottom surfaces 14, 16 can be substantially flat, andthe side surface 18 can be contoured. The side surface 18 can alsoinclude recessed slots 19 that improve handling of the drill guide 10.

The drill guide 10 can also include one or more coupling members 20. Thecoupling members 20 can be frusto-conically shaped projections thatextend from the bottom surface 16. As such, the coupling members 20 caneach include a tapered outer surface 22. The drill guide 10 can includeany number of coupling members 20. For instance, in the embodimentsillustrated, the drill guide 10 can include two coupling members 20(i.e., first and second coupling members 20). The coupling members 20can be spaced apart on opposite ends of the bottom surface 16.

Furthermore, as shown in FIGS. 1 and 2, the drill guide 10 can includeone or more through-holes 24. The through-holes 24 can each extendcontinuously through the main body 12 and a respective one of thecoupling members 20. A guide surface 26 can be defined by the innerdiameter surface of each through-hole 24. Each guide surface 26 can havea circular cross section with a diameter that remains substantiallyconstant along its length. The diameter of the guide surface 26 can alsoclosely correspond to a drill bit 27 (shown in phantom in FIG. 2) orother drilling tool. Thus, the drill bit 27 can rotate and move axiallythrough each through-hole 24, and the guide surface 26 can support thedrill bit 27 such that the drill bit 27 remains aligned with the axis ofthe through-hole 24 as the drill bit 27 moves toward its target (e.g., abone). Accordingly, the drill bit 27 can be supported and guided by thedrill guide 10 for forming holes in the bone as will be discussed. Then,as will be discussed, referencing pins can be inserted and fixed withinthe holes. Subsequently, cutting guides, resection guides, or othertools can be attached to the bone via the referencing pins.

As shown in FIG. 1, a plane Y (i.e., a guide plane) can be defined bythe longitudinal axes of the through-holes 24. Specifically, thelongitudinal axes of both through-holes 24 can extend along the plane Yin the embodiments of FIG. 1.

The femoral drill guide 10 can additionally include an alignmentconfirmation feature 28. The alignment confirmation feature 28 caninclude a block 30 with an opening 32 (i.e., an alignment opening)formed therethrough. The block 30 can include a plurality ofsubstantially flat sides, and the block 30 can extend from the topsurface 14 of the main body 12. The opening 32 can be a through-holethat extends through the block 30. As shown in FIG. 2, the opening 32can be elongated in cross-section so as to include a minor axis A and amajor axis B that is longer than the minor axis A. The opening 32 canalso include a longitudinal axis C (i.e., a confirmation axis) that issubstantially straight and that extends substantially perpendicular tothe plane Y as shown in FIG. 1.

The alignment confirmation feature 28 can be used for confirming thatthe patient-specific alignment guide 36 (FIG. 4) is aligned as intendedrelative to the bone before any holes are drilled in the bone. Then,once proper alignment has been confirmed, holes can be drilled in thebone using the drill guide 10. Next, referencing pins 46, bone nails, orother similar bone fasteners can be positioned in the holes as shown inFIG. 5, and a resection guide 48 or other tools can be attached to thosepins 46 to guide a resection tool 52, such as a reciprocating saw orcutting blade, after the patient-specific alignment guide 36 and thedrill guide 10 are removed from the distal femur 35. Accordingly, thealignment confirmation feature 28 of the drill guide 10 can ultimatelyensure that the referencing pins 46 and resection guide 48 will bealigned as intended relative to the bone.

It will be appreciated that the drill guide 10 can be a monolithic orunitary member made out of any suitable material. More specifically, theblock 30 and the coupling members 20 can be integrally attached to themain body 12 to form a monolithic structure. The drill guide 10 can bemade out of a metal (e.g., stainless steel), hard polymeric material,ceramic material, composite material, or any other material.Furthermore, the drill guide 10 can be formed in any suitable fashion(e.g., casting, milling, etc.). Additionally, it will be appreciatedthat the drill guide 10 can have various sizes and shapes, depending onthe size of the patient's anatomy, etc. Moreover, the drill guide 10 canbe designed and built preoperatively as will be discussed.

Referring now to FIGS. 4 & 5, the drill guide 10 is illustrated as partof the orthopedic device 34. The orthopedic device 34 can be used inpreparation for implanting a knee joint prosthesis. Specifically, asshown in FIGS. 4 and 5, the device 34 can be used in preparation forresecting the distal femur 35; however, the device 34 can be used beforeresecting any other bone or before performing any other suitablesurgical procedure.

For purposes of clarity, only the proximal and distal ends of thefemoral bone are shown in FIG. 4, and the ends are translated towardeach other along the mechanical axis M of the femoral bone. Moreover, itwill be appreciated that other portions of the leg (e.g., muscle tissue,connective tissue, other bones, etc.) are not shown for clarity.

As mentioned above, the orthopedic device 34 can include apatient-specific alignment guide 36. Patient-specific alignment guides36 and their method of manufacture are disclosed and described in detailin the commonly-owned, co-pending U.S. patent application Ser. No.11/756,057, filed on May 31, 2007, and published as U.S. PatentPublication No. 2007/0288030, which is hereby incorporated herein byreference in its entirety. The alignment guide 36 can be configuredpreoperatively to include a three-dimensional patient-specific surface38 that nests and closely conforms to a corresponding surface 37 of thedistal femur 35 in only one position. For instance, the patient-specificsurface 38 can be shaped and contoured to nest and closely conform to aportion of anterior and distal (i.e., condylar) surfaces 37 of thedistal femur 35 as shown in FIG. 4. Specifically, a three dimensionalelectronic model of the patient's knee joint or other anatomy can begenerated from Magnetic Resonance Imaging (MRI) or other imaging data ofthe patient's anatomy, and the patient-specific alignment guide 36 canbe designed such that the patient-specific surface 38 can becomplementary to and nestingly mate with a corresponding surface of thedistal femur 35 with or without articular cartilage. The drill guide 10(discussed above) can also be designed preoperatively to be operablycoupled to the alignment guide 36 as will be discussed. Thispreoperative design process can be performed, for instance, usingsoftware that is commercially available from Materialise USA ofPlymouth, Mich.

The alignment guide 36 can also include one or more frusto-conicprojections 39, each with a referencing hole 40 a, 40 b extendingtherethrough. The alignment guide 36 can include any number ofreferencing holes 40 a, 40 b, and the holes 40 a, 40 b can be in anyposition/orientation relative to the distal femur 35. In the embodimentsillustrated, for instance, the alignment guide 36 includes two anteriorholes 40 a and two distal holes 40 b. When the alignment guide 36 isnested on the distal femur 35, the anterior holes 40 a are directedgenerally toward the anterior surface of the distal femur 35, and thedistal holes 40 b are directed generally toward the distal surface ofthe distal femur 35. The alignment guide 36 can also be designed suchthat the holes 40 a, 40 b have a predetermined orientation relative tothe bone. For instance, when nested against the distal femur 35, theanterior holes 40 a can both be substantially perpendicular to amechanical axis M of the femoral bone. The mechanical axis M is definedbetween a centerpoint 43 of the femoral head 49 and a central point 41between the condylar surfaces of the distal femur 35.

As shown in FIG. 4, the drill guide 10 can operably couple to thealignment guide 36. Specifically, the coupling members 20 can besimultaneously received within the anterior holes 40 a. The anteriorholes 40 a can have a female-tapered shape so as to nest with thetapered outer surfaces 22 of the coupling members 20. When coupled assuch, the through holes 24 of the drill guide 10 can substantially alignwith the holes 40 a, respectively. Also, when the drill guide 10 ismounted to the alignment guide 36, the confirmation axis C can besubstantially parallel to a mechanical axis M of the femoral bone,assuming that the alignment guide 36 is aligned as intended relative tothe mechanical axis M.

The device 34 can additionally include an alignment rod 42. The rod 42can be rigid and elongate with a substantially straight axis R. The rod42 can have a substantially circular cross section, or the rod 42 canhave a different cross sectional shape. Also, the rod 42 can have awidth W (i.e., diameter) that allows the rod 42 to be received (e.g.,slidingly received) within the opening 32 of the drill guide 10. Forinstance, the width W can be substantially equal or slightly less thanthe minor axis A of the opening 32 (FIG. 2). However, the width W can besignificantly less than the major axis B of the opening 32. The rod 42can also include an enlarged head 45 that limits sliding movement of therod 42 relative to the drill guide 10.

The rod 42 can be slidingly received within the opening 32 of the drillguide 10 to thereby confirm that the alignment guide 36 is, in fact,properly aligned relative to the femoral bone (i.e., in a targetorientation). The target orientation can be any suitable orientationrelative to the femoral bone (e.g., relative to the mechanical axis M).For instance, the target orientation can be such that the plane Y issubstantially perpendicular to the mechanical axis M. If the alignmentguide 36 is at this target orientation, then the axis C should besubstantially parallel to the mechanical axis M. Thus, by sliding therod 42 along the axis C, the rod axis R should likewise be parallel tothe mechanical axis M. Otherwise, the rod 42 can be rotated about theaxis A (FIGS. 2 and 3) of the drill guide 10 (e.g., to avoidinterference with anatomical soft tissue) and the rod axis R can remainwithin a plane P defined by the mechanical axis M and the confirmationaxis C as shown in FIG. 4. If these conditions are satisfied, then it isconfirmed that the alignment guide 36 is properly aligned. Otherwise,the alignment guide 36 is misaligned.

It will be appreciated that the predetermined alignment or targetorientation of the alignment guide 36 could be relative to any otheranatomical feature or anatomic axis other than the mechanical axis M.Also, it will be appreciated that the predetermined alignment or targetorientation could be disposed at a predetermined offset angle relativeto the mechanical axis M.

Thus, during the surgical procedure, the patient-specific alignmentguide 36 can be nested against the corresponding surface 37 of thedistal femur 35. Then, the coupling members 20 of the drill guide 10 canbe removably inserted into the corresponding pair of referencing holes40 a of the guide 36 as shown in FIG. 4. Next, the rod 42 can beslidingly inserted into the opening 32 in the drill guide 10, and theorientation of the rod axis R can be inspected relative to themechanical axis M and the plane P. Specifically, it can be determined ifthe rod axis R lies substantially within the plane P. If so, it isconfirmed that the alignment guide 36 is properly aligned. If not,misalignment of the guide 36 can be recognized. Advantageously, thisprocedure can be performed before any holes are drilled or anyresections are made on the distal femur 35.

Once proper alignment of the guide 36 has been confirmed, the rod 42 canbe withdrawn. Then, the drill bit 27 (FIG. 2) can be introduced intoeach of the holes 24 of the drill guide 10, and anterior drill holes 44a (FIG. 5) can be formed in the distal femur 35 while being guided bythe guide surfaces 26 of the drill guide 10. Specifically, holes 44 a inthe distal, anterior portion of the distal femur 35 can be formed first.Distal holes 44 b for a cutting block can be formed through thereferencing holes 40 b of the alignment guide, as shown in FIG. 5.

Next, referencing pins 46 can be driven into respective ones of thedrill holes 44 a on the anterior surface of the distal femur 35 as shownin FIG. 5. Subsequently, a known distal resection guide 48 with a guidesurface 50 can be attached to the distal femur 35 by sliding the guide48 onto both pins 46. As shown in FIG. 5, the pins 46 are disposed onthe plane Y, which was previously confirmed to be perpendicular to themechanical axis M of the femoral bone. Thus, when a resection tool 52(e.g., a reciprocating blade) is guided toward the distal femur 35 bythe guide surface 50, the resection can be substantially perpendicularto the mechanical axis M, as desired.

Referring now to FIGS. 6-8, exemplary embodiments of a tibial drillguide 110 are illustrated. Components that correspond to those of theembodiments of FIGS. 1-4 are indicated with corresponding referencenumbers increased by 100.

As will be discussed, the tibial drill guide 110 can be used inconnection with resecting a tibia 155 (FIG. 9). However, the drill guide110 can be used for resecting another bone without departing from thescope of the present disclosure.

As shown, the opening 132 can extend directly through the main body 112of the drill guide 110. The opening 132 can also be substantiallycentered between the coupling members 120 such that the axis C of theopening 132 defines a line of symmetry of the main body 112.

Furthermore, the opening 132 can have a cross section that closelyconforms to that of the alignment rod 142 (FIG. 9). As such, the rod 142can only slide in a direction substantially parallel to the axis C ofthe opening 132.

Thus, as shown in FIG. 9, the drill guide 110 can be used duringresection of the tibia 155 to confirm that the alignment guide 136 isaligned relative to the mechanical axis M of the tibia 155. Themechanical axis M of the tibia 155 is defined by the tibial tubercle 151and a center point of the ankle 153.

Once alignment of the alignment guide 136 has been confirmed as shown inFIG. 9, the drill guide 110 can be used to guide the drilling of holesfor pins 146 (FIG. 10). Subsequently, the tibial resection guide 148 canbe attached to the tibia 155 via the pins 146 as shown in FIG. 10, andthe tibia 155 can be resected in a known manner.

Referring now to FIGS. 11-14, additional exemplary embodiments of thedrill guide 210 are illustrated. Components that correspond to those ofthe embodiments of FIGS. 6-8 are indicated with corresponding referencenumbers increased by 100. Like the embodiments of FIGS. 6-8, the drillguide 210 can be used in connection with resecting a tibia 255 (FIG.14). However, the drill guide 210 can be used for resecting another bonewithout departing from the scope of the present disclosure.

As shown, the opening 232 can extend directly through the main body 212of the drill guide 110. However, the opening 232 can be off-center suchthat the opening 232 is disposed adjacent a first end 263 and is spacedaway from a second end 265 of the main body 212. Furthermore, theopening 232 can be disposed on one side of the main body 112 relative tothe coupling members 220.

Thus, as shown in FIG. 14, the drill guide 210 can be used duringresection of the tibia 255 to confirm that the alignment guide 236 isproperly oriented relative to the mechanical axis M of the tibia 255.Once alignment of the drill guide 210 has been confirmed as shown inFIG. 14, holes can be drilled using the drill guide 210 and thesubsequent resection of the tibia 255 can be performed as discussedabove with respect to FIG. 10.

Accordingly, the drill guide 210 allows the surgeon to quickly andefficiently check that the alignment guide 236 is properly alignedrelative to the patient's anatomy. This check can be performed beforethe bone is drilled and/or resection cuts are made.

In summary, the orthopedic device 34, 134, 234 of the present teachingsprovide an intraoperative confirmation of the alignment ofpatient-specific alignment guides relative to corresponding mechanicalaxes of the bone prior to drilling or resection of the bone during anarthroplasty. The drill guide 10, 110, 210 is configured tointraoperatively couple to the patient-specific alignment guide 36, 136,236, and the alignment rod 42, 142, 242 can be coupled to the drillguide 10, 110, 210 to confirm that the alignment guide 36, 136, 236 isaligned as intended relative to the bone. This confirmation step can beperformed before any of the drill holes are formed in the bone. Thus,any unintended misalignment can be corrected early in the procedure.Accordingly, the procedure can be performed accurately and efficiently.

It will be appreciated that the drill guide 10, 110, 210 can vary in anumber of ways without departing from the scope of the presentdisclosure. For instance, the alignment confirmation feature 28, 128,228 of the drill guide 10, 110, 210 can be another feature other than anopening 32, 132, 232 that receives the rod 42, 142, 242. For instance,the alignment confirmation feature 28, 128, 228 could be a maleconnector, and the rod 42, 142, 242 could include a female opening thatreceives the male connector to thereby attach the rod 42, 142, 242 tothe drill guide 10, 110, 210. It will also be appreciated that the rod42, 142, 242 could be replaced by a laser pointer that is coupled to thealignment confirmation feature 28, 128, 228 of the drill guide 10, 110,210 to confirm that the alignment guide 36, 136, 236 is properlyaligned.

The foregoing discussion discloses and describes merely exemplaryarrangements of the present teachings. Furthermore, the mixing andmatching of features, elements and/or functions between variousembodiments is expressly contemplated herein, so that one of ordinaryskill in the art would appreciate from this disclosure that features,elements and/or functions of one embodiment may be incorporated intoanother embodiment as appropriate, unless described otherwise above.Moreover, many modifications may be made to adapt a particular situationor material to the teachings of the invention without departing from theessential scope thereof. One skilled in the art will readily recognizefrom such discussion, and from the accompanying drawings and claims,that various changes, modifications and variations can be made thereinwithout departing from the spirit and scope of the present teachings asdefined in the following claims.

What is claimed is:
 1. An orthopedic method comprising: intraoperativelynesting a three-dimensional patient-specific surface of apatient-specific alignment guide to a corresponding surface of a bone,the three-dimensional patient-specific surface being preoperativelyconfigured to align the patient-specific alignment guide relative to thebone when nested to the corresponding surface in only one position, thepatient-specific alignment guide including a first referencing hole anda second referencing hole; intraoperatively mounting a drill guide ontothe patient-specific alignment guide by inserting first and secondcoupling members of the drill guide into the first and secondreferencing holes, respectively, and aligning corresponding drillopenings of the first and second coupling members with the first andsecond referencing holes, respectively; intraoperatively confirming thatthe patient-specific alignment guide is aligned relative to a mechanicalaxis of the bone using an alignment confirmation feature of the drillguide, including passing a rod through an alignment opening of thealignment confirmation feature confirming that a rod axis of the rod isparallel to the mechanical axis of the bone; and drilling a hole intothe bone through one of the drill openings after confirming that thepatient-specific alignment guide is aligned relative to the mechanicalaxis of the bone.
 2. The method of claim 1, further comprising rotatingthe rod relative to the mechanical axis to avoid abutment of the rodwith an anatomical feature.
 3. The method of claim 1, furthercomprising: drilling a plurality of holes in the bone with the drillingtool; inserting a referencing pin into each of the plurality of holes;removing the patient-specific guide and the drill guide without removingthe referencing pins; mounting a resection guide onto the referencingpins; and resecting the bone with a resection tool that is guided by theresection guide.
 4. An orthopedic method comprising: nesting athree-dimensionally mirrored patient-specific surface of an alignmentguide against a three-dimensional surface of a bone to attach a drillguide to the bone; inserting a rod into an opening in the drill guide;determining if the rod lies substantially within a predetermined planerelative to a mechanical axis of the bone; withdrawing the rod;utilizing the drill guide as a reference for attaching a resection guideto the bone, wherein attaching the resection guide comprises: preparingholes in the bone using the drill guide; driving referencing pins intothe prepared holes; removing the alignment guide and the drill guideprior to attaching the resection guide; and attaching the resectionguide onto the referencing pins; and guiding a resection tool toward thebone via a guide surface in the resection guide.
 5. The orthopedicmethod of claim 4, further comprising inserting coupling members of thedrill guide into reference holes of the alignment guide to attach thedrill guide to the alignment guide.
 6. The orthopedic method of claim 5,further comprising: introducing a drill bit into a first set of holes inthe drill guide that align with a first set of holes in the alignmentguide; and forming first holes in the bone at the first set of holes inthe alignment guide and the drill guide.
 7. The method of claim 6,wherein the bone comprises a tibia and the first set of holes arelocated on the tibia substantially perpendicular to the mechanical axis.8. The orthopedic method of claim 7, wherein the three-dimensionallymirrored patient-specific surface of the alignment guide complements andmates with an anterior surface of the tibia.
 9. The method of claim 6,wherein the bone comprises a femur and the first set of holes arelocated on the femur substantially perpendicular to the mechanical axisand the second set of holes are located on the femur substantiallyparallel to the mechanical axis.
 10. The orthopedic method of claim 9,wherein the three-dimensionally mirrored patient-specific surface of thealignment guide complements and mates with distal and anterior condylarsurfaces of the femur.
 11. The orthopedic method of claim 6, furthercomprising forming second holes in the bone at a second set of holes inthe alignment guide.
 12. The method of claim 4, further comprisingcorrecting alignment of the alignment guide if the rod does not liesubstantially in the plane.